DENIAL AND AUDIT MANAGEMENT
Our Denial and Audit Management module will help maximize efficiency with cross-department workflow management tools that will identify, track and manage denied and audited claims while uncovering the root causes of repetitive problems.

Managing Payments

Make posting and reconciling payments quick and concise with our solutions

Manage electronic remits

Simplify reconciliation process

REMITTANCE MANAGEMENT
Streamline electronic remittance in a complete and comprehensive system with our Remittance Management module.

DEPOSIT BANK RECONCILIATION
Save time and improve efficiency with our Deposit Bank Reconciliation. Matching remits and deposits are automatically reconciled; mismatches are sent to work queues to be reviewed.

Contract Management & Reporting

Ensure you receive the correct payment for every claim, every time

Ensure full and fair reimbursement for every claim

Report on all financial details of both current and archived claims and remits

CONTRACT MANAGEMENT
Examine claims before they are submitted and after they are returned, ensuring both accurate payment prediction and validation. Our Contract Management module provides the tools to take control of payer contracts and stop performing random claim audits.

REPORTING AND DATA MINING
Improve efficiency and productivity with the ability to report on every financial detail of both claims and remits with more than 350 standard reports, more than 200 drill-down graphs and unlimited ad hoc reporting.

Additional Tools

PHARMACY ONLINE ADJUDICATION
Provide patients with their copay, deductible and coinsurance amounts as claims are processed in real time.

MEDICAL NECESSITY DATABASE
Ensure that your hospital consistently bases patient tests and procedures on the latest available criteria including Local Coverage Determinations for insurance as well as the CMS-mandated Lab National Coverage Determination Policies.